Eat better and improve your mental
state? That’s what the new field of nutritional psychiatry has been
telling us for some time. Observational studies support the contention
that diet quality is a possible risk or protective factor for
depression. A randomized controlled trial from Australia earlier this
year confirmed that observation. Called SMILES (Supporting
the Modification of lifestyle In Lowered Emotional
States) the 12 week study, published January 30, 2017, in BMC
Medicine, enrolled 67 people who had moderate to severe depression
and poor diets and randomized them into a diet group and a social
support (control) group.

The intervention was that the diet
group was encouraged to eat whole grains, vegetables, fruits, legumes,
low-fat and unsweetened dairy foods, nuts, lean meats, and olive oil—and
reduce refined grains, sweets, fried or fast foods, processed foods,
processed meats, and sugary drinks. Moderate alcohol consumption was
also permitted; no more than two standard drinks. In short, they were
counseled to follow a whole foods Mediterranean diet approach.

The social support control group met
with a clinician on the same schedule, but discussed neutral topics such
as sports and music or engaged in board games and other activities.The idea was to make sure that one
group didn’t do better than the other simply because they spent more
time with the clinician.

After 12 weeks, the diet group
demonstrated significantly greater reduction in depression and anxiety
symptoms than the social support group. At the end of the trial, the
diet group saw a 32 percent remission in depression, compared to 8
percent in the control group.

Importantly, the people who improved
their diet the most were the ones who experienced the most improvement
in mood. For about 1/3 of the diet group, depression symptoms dropped
below the threshold for diagnosis. They were cured.

Jacka et al concluded: “[T]his is
the first RCT to explicitly seek to answer the question: If I improve my
diet, will my mental health improve? Whilst emphasizing the preliminary
nature of this study and the imperative for replication in studies with
larger sample sizes, the results of our study suggest that dietary
improvement guided by a clinical dietician may provide an efficacious
treatment strategy for the management of this highly prevalent mental
disorder.”

A randomized controlled trial (RCT)
is considered the ‘gold standard’ of research methods. So the results of
this study carry considerable weight.

Why Is This Study
Important?

Professor Jacka, who is director of
the Food and Mood Centre and president of the International Society for
Nutritional Psychiatry Research, said the findings offered an important
new strategy for the treatment of depression.

“Mental disorders account for the
leading cause of disability worldwide, with depression accounting for
the large proportion of that burden,” she said. “While approximately
half of sufferers are helped by currently available medical and
psychological therapies, new treatment options for depression are
urgently needed.”

She continued: “Importantly,
depression also increases the risk of and, in turn, is also increased by
common physical illnesses such as obesity, type 2 diabetes and heart
disease. Successfully improving the quality of patients’ diets would
also benefit these illnesses.”
http://foodandmoodcentre.com.au/media/smiles-trial/

My Take

Like me, you are probably wondering
about the definition of depression. The Mayo Clinic offers one that’s
easy to understand: Depression is a mood
disorder that causes a persistent feeling of sadness and loss of
interest. Also called major depressive disorder or clinical depression,
it affects how you feel, think and behave and can lead to a variety of
emotional and physical problems. You may have trouble doing normal
day-to-day activities, and sometimes you may feel as if life isn't worth
living.

It’s remarkable that something as
basic as diet can cure a third of people with moderate to severe
depression. It might shorten the appointment book of psychiatrists and
add to that of dieticians. It certainly moves diet up the list of
treatments for depression. Makes sense when you consider the effect low
quality eating can have on blood sugar fluctuations—and mood.

In my first book Ripped,I wrote about the dramatic effect a very low carbohydrate diet had
on my mood. I was “more than tired…My mental condition bordered on
paranoia.” Eating two big nectarines brought me out of it. “I felt like
a new person…I left the house an exhausted Mr. Hyde and returned a
revived Dr. Jekyll.”

Dr. Jacka and her team listed more
complex ways diet may influence depression. “There are many other
biological pathways by which dietary improvement may influence
depressive illness; previous discussions have centered on inflammatory
and oxidative stress pathways, as well as brain plasticity and the new
evidence base focused on the gut microbiota. Each of these pathways is
suggested to play a role in depression and is also influenced by diet
quality.” They also listed more mundane factors. “Moreover, behavioral
changes associated with food (cooking/shopping/meal patterns) are an
expected outcome of a nutrition intervention, and these changes in
activity may also have had a therapeutic benefit.”

Like most people, I feel down at times. I usually come
out of it by finding something meaningful to do.
Bill Reynolds, who took
this photo of me in this breathtaking setting, was a brilliant and sensitive
person
with powerful emotional swings. He also ate unwisely. I saw him
spoon sugar into his Coke.
Joe Weider asked him why he did that to
himself. He had no answer.

Most of us have had short bouts of
depression or anxiety. I know that I have. My solution is usually to turn my mind
to something challenging. Walking also helps. Coffee can also have a
rebound effect, dampening spirits after a time. In the future I’ll check
to see how long it has been since I had a quality meal. I have no doubt
that food can have a powerful effect on mood.

Mayo Clinic adds this serious but
hopeful caveat: More than just a bout of the
blues, depression isn't a weakness and you can't simply "snap out" of
it. Depression may require long-term treatment. But don't get
discouraged. Most people with depression feel better with medication,
psychotherapy or both.